Age, gender, peers, life skills and quality of life influence risk of cell phone addiction among college teachers in Karnataka, India : a state level epidemiological analysis.

BACKGROUND: Cell phones are an integral part of modern day life and have become companions for individuals irrespective of age, gender and socio-economic status. In this study, we assessed the factors affecting risk of cell phone addiction among teachers attending Life Skills Training and Counselling Services (LSTCS) program in Karnataka. METHODS: This cross sectional secondary data analysis utilised data from baseline assessment of trainees attending a Life Skills Training and Counselling Services program (LSTCP). Various factors hypothesised to be affecting risk of cell phone addiction (outcome) was analysed using univariate and multivariable logistic regression analysis. All the analysis was done using STATA 12.0 software. RESULTS: Multivariable logistic regression analysis was conducted with risk of cell phone addiction as outcome. A conceptual framework of hypothesized exposure variables was developed based on expert consultation and literature review. Overall, data of 1981 participants was utilized. Gender (AOR=1.91; 95% CI=1.27-2.77), number of peers (AOR=1.01; 95 CI=1-1.008) and social quality of life (AOR=1.01; 95% CI=1.00-1.03) were associated with increased risk of cell phone addiction. Age (AOR=0.98; 95%CI=0.96-1.00), empathy (AOR=0.96;95%;CI=0.93-0.99), communication skills(AOR=0.92, 95%;CI=0.88-0.96) and physical quality of life (AOR=0.96; 95% CI=0.95-0.98) were associated with reduced risk of cell phone addiction. CONCLUSIONS: This study on precursors of risk of cell phone addiction, conducted mostly among apparently healthy individuals, provide important insights into interventions to reduce risk of cell phone addiction. The complexity of associations between peers, gender, quality of life and risk of cell phone addiction needs further exploration.

Prevalence of Common mental disorders in older adults: Results from the National Mental Health Survey of India.

OBJECTIVE: We estimate the prevalence of common mental disorders (CMD) among older adults and compare them with that of younger adults at the national level. METHOD: We analysed data on older adults from the National Mental Health Survey of India undertaken across 6 regions and 12 states of India during 2015-16. Multi-stage cluster sampling technique was adopted which permitted state level and subsequently pooled national estimates. Mini International NeuroPsychiatric Interview (MINI) adult version 6.0 was used for measuring psychiatric morbidity. RESULTS: Older adults had a higher lifetime (6.93%) and current (3.53%) prevalence of depressive disorders as compared to the younger adults (4.96% and 2.54%). There was no difference in the prevalence of anxiety disorders in different agegroups. The most prevalent anxiety disorder in older adults was specific phobias (1.72%) followed by agoraphobia (1.6%). All CMD in the older population were more common in females, those living in urban metros, the unemployed, who were not currently married and those with lower household income. DISCUSSION: These findings support planning better mental health policies and programs for older adults in India.

The burden of active infection and anti-SARS-CoV-2 IgG antibodies in the general population: Results from a statewide survey in Karnataka, India

BackgroundGlobally, the routinely used case-based reporting and IgG serosurveys underestimate the actual prevalence of COVID-19. Simultaneous estimation of IgG antibodies and active SARS-CoV-2 markers can provide a more accurate estimation. MethodsA cross-sectional survey of 16416 people covering all risk groups was done between 3-16 September 2020 using the state of Karnatakas infrastructure of 290 hospitals across all 30 districts. All participants were subjected to simultaneous detection of SARS-CoV-2 IgG using a commercial ELISA kit, SARS-CoV-2 antigen using a rapid antigen detection test (RAT), and reverse transcription-polymerase chain reaction (RT-PCR) for RNA detection. Maximum-likelihood estimation was used for joint estimation of the adjusted IgG, active, and total prevalence, while multinomial regression identified predictors. FindingsThe overall adjusted prevalence of COVID-19 in Karnataka was 27 {middle dot}3% (95% CI: 25 {middle dot}7-28 {middle dot}9), including IgG 16 {middle dot}4% (95% CI: 15 {middle dot}1 - 17 {middle dot}7) and active infection 12 {middle dot}7% (95% CI: 11 {middle dot}5-13 {middle dot}9). The case-to-infection ratio was 1:40, and the infection fatality rate was 0 {middle dot}05%. Influenza-like symptoms or contact with a COVID-19 positive patient are good predictors of active infection. The RAT kits had higher sensitivity (68%) in symptomatic participants compared to 47% in asymptomatic. InterpretationThis is the first comprehensive survey providing accurate estimates of the COVID-19 burden anywhere in the world. Further, our findings provide a reasonable approximation of population immunity threshold levels. Using the RAT kits and following the syndromic approach can be useful in screening and monitoring COVID-19. Leveraging existing surveillance platforms, coupled with appropriate methods and sampling framework, renders our model replicable in other settings.

A comparison of observed and self-reported helmet use and associated factors among motorcyclists in Hyderabad city, India.

OBJECTIVES: India has a high burden of fatal road traffic injuries (RTIs). A large proportion of fatal RTIs in India are among motorcyclists. The overall goal of this study is to assess and compare observed and self-reported prevalence of helmet use; and to identify factors associated with helmet use and over-reporting in Hyderabad city, India. STUDY DESIGN: Roadside knowledge, attitude and practice interviews. METHODS: Six rounds of roadside interviews were conducted with motorcyclists (drivers and pillion riders) between July 2011 and August 2013 using a structured tool developed for this study. Observations on helmet use were recorded and respondents were also asked if they 'always wear a helmet'. Prevalence of helmet use was calculated and a paired t-test was used to compare observed and self-reported helmet use proportions. Unadjusted and adjusted odds ratios were calculated to identify factors associated with helmet use and over-reporting. RESULTS: A total of 4872 respondents participated in the roadside interview. The response rate was 94.4%. The overall observed helmet use was 34.5% and 44.5% of respondents reported that they 'always wear a helmet'. As the observed helmet use increased, the over-reporting of helmet use was found to decrease. However, factors associated with observed and self-reported helmet use are similar. Male gender, youth (≤24 years), a lower level of education and non-ownership of helmet were associated with a higher risk of not wearing helmets. Male gender, youth (≤24 years), no schooling, riding a lower engine capacity motorcycle and using a motorcycle for purposes other than travelling to school/work were associated with over-reporting of helmet use. CONCLUSIONS: Self-reports provide an overestimate of helmet use that lessens as actual helmet use increases. Interviews also allow identification of factors associated with helmet use. Increasing helmet ownership and enhanced enforcement may help increase helmet use.

Comparative analysis of three prehospital emergency medical services organizations in India and Pakistan.

OBJECTIVES: Strengthened emergency medical services (EMS) are urgently required in South Asia to reduce needless death and disability. Several EMS models have been introduced in India and Pakistan, and research on these models can facilitate improvements to EMS in the region. Our objective was to conduct a cross-case comparative analysis of three EMS organizations in India and Pakistan - GVK EMRI, Aman Foundation and Rescue 1122 - in order to draw out similarities and differences in their models. STUDY DESIGN: Case study methodology was used to systematically explore the organizational models of GVK EMRI (Karnataka, India), Aman Foundation (Karachi, Pakistan), and Rescue 1122 (Punjab, Pakistan). METHODS: Qualitative methods - interviews, document review and non-participant observation - were utilized, and using a process of constant comparison, data were analysed across cases according to the WHO health system 'building blocks'. RESULTS: Emergent themes under each health system 'building block' of service delivery, health workforce, medical products and technology, health information systems, leadership and governance, and financing were described. Cross-cutting issues not applicable to any single building block were further identified. CONCLUSIONS: This cross-case comparison, the first of its kind in low- and middle-income countries, highlights key innovations and lessons, and areas of further research across EMS organizations in India, Pakistan and other resource-poor settings.

Assessment of Health Systems and Services Including Availability of Components for Mental Health Care in Industries of Kolar District, India.

BACKGROUND: Non-communicable diseases (NCDs) and psychological hazards are increasingly observed in industries, necessitating the need to strengthen industrial health systems to control the same. District level data on level of functioning of industrial health systems and services with special focus on systems available for mental health care is lacking in India. This information is vital to plan need-based interventions for system strengthening. OBJECTIVE: To assess the status of functioning of industrial health systems and services in Kolar district, India, with special focus on systems and services available for mental health care. METHODS: This cross-sectional study was undertaken between October and December 2014 on a stratified random sample of 69 industries located in Kolar, which were stratified proportionately by their hazardous nature. Interview and observation checklist were used to assess and classify functioning of industrial health systems and services including those available for mental health care. RESULTS: Occupational safety and health (OSH) policy was present in 56% and health insurance in 39% of the 69 industries assessed. Pre-placement and periodical medical examination were conducted in 23% of industries. Health systems and services in hazardous industries were functioning at less than 50% level of functioning. Health systems and services for mental health care were non-existent. CONCLUSION: There is a need in Kolar district, India, to integrate the mental health components within existing industrial health systems, as per policy directives to implement setting based approaches in mental health programs.

Feasibility of integrating mental health and noncommunicable disease risk factor screening in periodical medical examination of employees in industries: An exploratory initiative.

BACKGROUND: Noncommunicable disease (NCDs), psychological, substance use disorders, and stress-related issues have been less understood in Indian industrial settings. Systems for screening and early identification of the above have not been integrated in workplaces, nor there is a strong regulatory backing for the same. AIM: To explore the feasibility of integrating mental health and select NCD risk factor screening with the periodical medical examination of employees. To identify proportion of employees with select NCD risk factors and symptoms suggestive of mental health problems. SETTINGS AND DESIGN: Around 10% of employees from a leading motor industry in Bangalore, (706) participated in this cross-sectional voluntary screening program. MATERIALS AND METHODS: This screening was conducted as a part of their annual medical examination. A mixed method of self-report and interview administered technique was adopted for the same. STATISTICAL ANALYSIS: Descriptive statistical methods (proportions, median, mean, and standard deviation (SD)) and Chi-square test of significance. RESULTS AND CONCLUSIONS: Screening revealed the following; tobacco use (18%), alcohol use (57%), perceived work stress (10%), and obesity (3%). Nearly 23% screened positive for psychological distress. Time consumed for this assessment was 1-5 min. Initial attempts point out that it is feasible to integrate screening for mental health, substance use, and NCD risk factors in periodic medical examination using a combination of self-report and interview-administered method, though further detailed assessments for confirmation is necessary.

Brushing-induced surface roughness of two nickel based alloys and a titanium based alloy: a comparative study - in vitro study.

BACKGROUND: Alloys with high nickel content have been increasingly used in dentistry. Alloys have high corrosion rates when exposed to chemical or physical forces that are common intra orally. Titanium is the most biocompatible materials for crowns, fixed partial dentures and implants in the present use, but paradoxically the self-protective oxide film on the titanium can be affected by excessive use of the most common preventive agents in dentistry. Therefore, this study is undertaken in order to draw attention toward the potential effect of prophylactic brushing in a saline medium. MATERIALS AND METHODS: Forty-five wax patterns in equal dimensions of 10 mm × 10 mm × 2 mm were cast in titanium (Grade II) and nickel-chromium. Of the 45 wax patterns, 15 wax patterns were used for preparing cast titanium samples and 30 wax patterns were used for preparing cast nickel-chromium samples and polished. These samples were divided into three groups of 15 samples each. They are brushed for 48 h each clinically simulating 2 years of brushing in a saline tooth paste medium. The surface roughnesses of the samples were evaluated using profilometer, scanning electron microscopes and energy dispersive spectroscopy. RESULTS were subjected to statistical analysis. RESULTS: The statistical analysis of the Rz and Ra surface roughness values were calculated. Significant difference of surface roughness was present in the titanium samples compared to that of the machine-readable cataloguing and Wirolloy (nickel-chromium) samples after the study. To know the difference in the values of all samples before and after, Student's paired t-test was carried out. RESULTS showed that there is a significant change in the Rz and Ra values of titanium samples. CONCLUSION: The present findings suggest that, prophylactic brushing with the fluoridated toothpaste have an effect on the surface roughness of titanium and also to a certain extent, on nickel-chromium. Therefore, careful consideration must be given to the selection of the toothbrushes and toothpastes with the medium abrasives in patients with these restorations. How to cite the article: Acharya BL, Nadiger R, Shetty B, Gururaj G, Kumar KN, Darshan DD. Brushing induced surface roughness of two nickel based alloys and a titanium based alloy: A comparative study - In vitro study. J Int Oral Health 2014;6(3):36-49.

Characterization of a fluorescent probe for imaging nitric oxide.

BACKGROUND: Nitric oxide (NO), a potent vasodilator and anti-atherogenic molecule, is synthesized in various cell types, including vascular endothelial cells (ECs). The biological importance of NO enforces the need to develop and characterize specific and sensitive probes. To date, several fluorophores, chromophores and colorimetric techniques have been developed to detect NO or its metabolites (NO(2) and NO(3)) in biological fluids, viable cells or cell lysates. METHODS: Recently, a novel probe (NO(550)) has been developed and reported to detect NO in solutions and in primary astrocytes and neuronal cells with a fluorescence signal arising from a nonfluorescent background. RESULTS: Here, we report further characterization of this probe by optimizing conditions for the detection and imaging of NO products in primary vascular ECs, fibroblasts, and embryonic stem cell- and induced pluripotent stem cell-derived ECs in the absence and presence of pharmacological agents that modulate NO levels. In addition, we studied the stability of this probe in cells over time and evaluated its compartmentalization in reference to organelle-labeling dyes. Finally, we synthesized an inherently fluorescent diazo ring compound (AZO(550)) that is expected to form when the nonfluorescent NO(550) reacts with cellular NO, and compared its cellular distribution with that of NO(550). CONCLUSION: NO(550) is a promising agent for imaging NO at baseline and in response to pharmacological agents that modulate its levels.

Qualitative study to explore stakeholder perceptions related to road safety in Hyderabad, India.

The Bloomberg Philanthropies Global Road Safety Programme in India focuses on reduction of drink driving and increase in helmet usage in the city of Hyderabad. During the early stages of implementation, perceptions of stakeholders on road safety were explored as part of the monitoring and evaluation process for a better understanding of areas for improving road safety in Hyderabad. Fifteen in-depth interviews with government officials, subject experts, and road traffic injury victims, and four focus group discussions with trauma surgeons, medical interns, nurses, and taxi drivers were conducted, analysed manually, and presented as themes. Respondents found Hyderabad unsafe for road-users. Factors such as inadequate traffic laws, gaps in enforcement, lack of awareness, lack of political will, poor road engineering, and high-risk road users were identified as threats to road safety. The responsibility for road safety was assigned to both individual road-users and the government, with the former bearing the responsibility for safe traffic behaviour, and the latter for infrastructure provision and enforcement of regulations. The establishment of a lead agency to co-ordinate awareness generation, better road engineering, and stricter enforcement of traffic laws with economic and non-economic penalties for suboptimal traffic behaviour, could facilitate improved road safety in Hyderabad.

Sleep-related disorders among a healthy population in South India.

INTRODUCTION: Sleep-related disorders (SRDs) though frequent, are under-reported and their implications are often neglected. OBJECTIVE: To estimate SRDs in an apparently healthy South Indian population. MATERIALS AND METHODS: Data was collected by administering a questionnaire including Sleep Disorders Proforma, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index (PSQI) to 1050 apparently healthy attendants/relatives of patients attending a tertiary healthcare institution. RESULTS: The mean age of the respondents was 35.1±8.7 years with even gender distribution (male: female; 29:21), work hours were 7.8±1.33 h and had regional representation from the southern Indian states. The majority of the respondents did not report any significant medical/psychiatric co-morbidities, hypertension was noted in 42.6%, in one-fourth, the body mass index (BMI) was >25, and in 7.7% the neck size was >40 cm. Daily tea (70.3%) and coffee (17.9%) consumption was common and 22.2% used tobacco. Average time-to-fall-asleep was 22 min (range: 5-90 min), average duration-of-actual-sleep was 7 h (range: 3.5-9.1 h) with the majority (93.8%) reporting good-quality sleep (global PSQI ≤5). The reported rates of SRDs varied between 20.0% and 34.2% depending on the instrument used in the questionnaire. Insomnia, sleep-related breathing disorders (SRBD), narcolepsy, and restless legs syndrome (RLS) were reported by 18.6%, 18.4%, 1.04% and 2.9%, respectively. Obesity was not strongly associated with SRBD. in 51.8% of subjects with SRBD BMI was <25 kg/m 2 . Of the respondents with insomnia, 18% had difficulty in initiating sleep, 18% in maintaining sleep and 7.9% had early morning awakening. Respondents attributed insomnia to depression (11.7%) or anxiety (2.5%). Insomnia was marginally high in females when compared to males (10.3% vs. 8.3%) and depression was the major reason. RLS, which was maximal at night, was responsible for delayed sleep onset (74.2%). Other SRDs included night terrors (0.6%), nightmares (1.5%), somnambulism (0.6%), and sleep-talking (2.6%). Family history of SRDs was present in 31.4% respondents. While, only 2.2% of the respondents self-reported and acknowledged having SRD, health-seeking was extremely low (0.3%). CONCLUSION: SRDs are widely prevalent in India. Considering the health implications and poor awareness, there is a need to sensitize physicians and increase awareness among the public.

Unintentional injury deaths among children younger than 5 years of age in India: a nationally representative study.

OBJECTIVE: To determine the mortality burden associated with unintentional injuries among children younger than 5 years of age in India. METHODS: The Registrar General of India conducted verbal autopsy for all deaths occurring in 2001-2003 in a nationally representative sample of over 1.1 million homes. These verbal autopsy reports were coded by two of 130 trained physicians, who independently assigned an ICD-10 code to each death. Discrepancies were resolved through reconciliation and, if necessary, adjudication. The probability of death during the first 5 years of life (per 100,000 live births) was estimated from the 2005 United Nations' population and death estimates for India, to which the proportions of deaths from the mortality study were applied. RESULTS: Unintentional injuries were the sixth leading cause of death among children under 5 years of age. In 2005, unintentional injuries led to 82,000 deaths (99% CI 71,000 to 88,000) among children under 5 years of age, a mortality rate per 100,000 live births (MR) of 302 (99% CI 262 to 323). Mortality was higher in rural areas (MR=339, 99% CI 282 to 351), mostly due to more drowning deaths, than in urban areas (MR=173, 99% CI 120 to 237), where falls were the leading cause of child injury mortality. CONCLUSION: Unintentional injuries, specifically drowning and falls, lead to substantial mortality in children younger than 5 years of age in India. There is a need for continued monitoring of the injury burden and investigation of risk factors for evidence-based effective injury prevention programmes.

Alcohol use and implications for public health: patterns of use in four communities.

BACKGROUND: Alcohol is one of the leading causes of death and disability globally and in India. Information on quantum and pattern of consumption is crucial to formulate intervention programs. OBJECTIVES: To identify the extent and pattern of alcohol use in urban, rural, town and slum populations using a uniform methodology. MATERIALS AND METHODS: Door-to-door survey was undertaken and simple random sampling methodology was adopted; households were the primary sampling unit. One respondent in each alcohol-user household was randomly chosen for detailed interview. RESULTS: Overall, 13% of males and females consumed alcohol. Proportion of users was greater in town (15.7%) and among 26-45 years (67.4%). Whisky (49%) and arrack (35%) were the preferred types and the preferences differed between rural (arrack) and urban (beer) areas. Nearly half (45%) of rural population were very frequent users (consuming daily or every alternate-days) as against users in town (23%) or slum (20%). Two-thirds were long-term users and the proportions were greater in the rural and town areas. While, overall 17% of the users were heavy-users, frequent-heavy-drinking was more in slum and rural areas. Nearly two-thirds consumed alcohol in liquor-shops, restaurants, bars and pubs. Habituation and peer-pressure were the key reasons for alcohol use. CONCLUSIONS: The study documented alcohol use and patterns of use in four different communities particularly in transitional areas using similar methodology. Many of the patterns identified are detrimental to health both immediate and over the long period of time.

A Multi-sectoral Approach to Capture Information on Road Traffic Injuries.

BACKGROUND: Regularly available data is shown to be inadequate for developing, implementing, and evaluating injury prevention and control programs in India. The present study was undertaken in the hospitals of Bangalore and Pune, to examine the feasibility of gathering information on injuries using multiple sources. MATERIALS AND METHODS: Stakeholders meeting and training programs were held for the hospital staff, police personnel, and traffic and transport staff, to identify their roles and responsibilities. Prospective data on morbidity and mortality due to injuries were collected by trained staff from Emergency Departments on a pre-tested questionnaire. The information gathered was cross-checked with the hospital and police records. RESULTS: The stakeholders meeting and training programs were able to motivate the departments to provide the correct data. Data on 32188 patients could be extracted from hospital and police records during the study period. Injuries accounted for 16% of the emergency cases. Unintentional injuries were 64%, and 32% were intentional. Road traffic injuries accounted for 44% of all the injuries. One-third of the injured were children and young adults below 25 years. Among the injured, two wheeler riders were 29% and pedestrians were 23%. CONCLUSION: It was possible to improve the data on injuries by adequate training and a data linking mechanism between the Police, Hospital, and Transport Departments. The problem of road traffic injuries could be highlighted and addressed by a good data capture mechanism.

Feasibility study of stroke surveillance: data from Bangalore, India.

BACKGROUND & OBJECTIVE: Stroke is a leading cause of deaths, and disabilities in India. Reliable and good quality data on epidemiological characteristics of stroke are essential to plan, implement and evaluate stroke prevention and control programmes. A feasibility study was undertaken in Bangalore to examine the possibility of establishing stroke surveillance and to develop methodology for a larger programme. METHODS: The study adapted WHO STEPs-STROKE methodology to collect data on hospitalized stroke events and fatal stroke events in the city of Bangalore. In STEP I, Information was collected from 1,174 stroke patients in three large hospitals and were followed till discharge and 28 days; outcome was measured as death or disability. Stroke cases fulfilling diagnostic criteria, evaluated by neurologists and CT/MRI confirmed cases were included. Brief information on major risk factors was collected from all stroke patients / family members and from medical records by trained research officers. In STEP II, death records of Bangalore Mahanagara Palike for 2004 (n=23,312) were analyzed to identify stroke related deaths. RESULTS: Using WHO-STEPs approach, a methodology was developed for stroke surveillance in a geographically defined population. By STEP 1 method--7 per cent of medical and 45 per cent of neurological admissions were due to stroke with a fatality rate of 9 per cent at hospital discharge and 20 per cent at 28 days. With a mean age of 54.5 (+/- 17.0) yr and male preponderance, nearly half had one or more risk factors. Weakness or paresis (92%) was the commonest presentation and ischaemic stroke was most frequent (73.8%). One third of total stroke patients were dependent at both discharge and 28 day follow up. By STEP II method the proportional mortality rate for Bangalore city was observed to be 6 per cent and more than 50 per cent of total stroke deaths had occurred in 10 major hospitals. INTERPRETATION & CONCLUSION: The present study has shown that stroke surveillance is possible and feasible. Institution based (hospitals and vital registry data) stroke surveillance supplemented with periodical population based information can provide comprehensive information on vital aspects of stroke like mortality, risk factors, disability and outcome. There is a need to develop stroke surveillance in a phased manner along with mechanisms to apply data for prevention and control programmes.

High occurrence and low recognition of Parkinsonism (and possible PD) in old age homes in Bangalore, South India.

BACKGROUND: The elderly population in developing countries is likely to increase by 200-280%. Age related diseases like Parkinsonism are also likely to increase in ageing population. The prevalence and awareness of Parkinsonism (and possible PD) amongst them are unknown. METHODS AND MATERIAL: The objective was to know the awareness and occurrence of Parkinsonism (and possible PD) in Old Age Homes in Bangalore, South India. The study design was prospective, direct clinical evaluation, and it was old age homes in Bangalore, South India setting. There were six hundred and twelve residents of the old age homes in Bangalore. A movement disorder neurologist examined 612 elderly residents living in Old age Homes in Bangalore city, India. RESULTS: Parkinsonism was diagnosed in 109 (17.8%) of 612 residents. Possible PD was diagnosed in 9 (1.5% of 612) while in 100 (16.3% of 612) definite PD was diagnosed.94 (86.2%) had bilateral Parkinsonian signs (Stage > or = 2 of Hoehn & Yahr), only 4 (3.7%) of them or the caregivers knew they had PD. CONCLUSIONS: Knowledge about the disease was very low in the elderly residents although the occurrence of Parkinsonism was very high. Improving awareness of PD amongst the elderly and their caregivers might reduce their disability and improve their quality of life.

Road traffic deaths, injuries and disabilities in India: current scenario.

In 2005, road traffic injuries resulted in the death of an estimated 110,000 persons, 2.5 million hospitalizations, 8-9 million minor injuries and economic losses to the tune of 3% of the gross domestic product (GDP) in India. If the present trend continues, India will witness the deaths of 150,000 persons and hospitalization of 3 million people annually by 2010, increasing further to 200,000 deaths and more than 3.5 million hospitalizations annually by 2015. Nearly 10%-30% of hospital registrations are due to road traffic injuries and a majority of these people have varying levels of disabilities. A majority of victims of road traffic injuries are men in the age group of 15-44 years and belong to the poorer sections of society. Also, a vast majority of those killed and injured are pedestrians, motorcyclists and pillions riders, and bicyclists. A clearly defined road safety policy, a central coordinating agency, allocation of adequate resources, strict implementation of proven and effective interventions and reliable information systems are urgently required. Greater participation from health and other sectors based on an integrated, intersectoral and coordinated approach is essential. Health professionals can contribute in numerous ways and should take a lead role in reducing the burden of road traffic injuries in India.

Family burden, quality of life and disability in obsessive compulsive disorder: an Indian perspective.

BACKGROUND: Obsessive compulsive disorder (OCD) is a psychiatric disorder that often tends to run a chronic course. The lifetime prevalence of OCD is around 1-3%, which is twice as prevalent as schizophrenia and bipolar disorder. AIM: To asses the family burden, quality of life (QoL) and disability in patients suffering from at least moderately ill OCD and then to compare them with schizophrenia patients of comparable severity. SETTINGS AND DESIGN: We recruited 70 consecutive subjects (OCD=35, schizophrenia=35) who met study criteria between March 2005 and March 2006 from the psychiatric services of the National Institute of Mental Health and Neuro Sciences, Bangalore, India. MATERIALS AND METHODS: The severity of illness was rated using the Clinical Global Impression-Severity (CGI-S). Instruments used in the current study were the Family Burden Schedule, the World Health Organization (WHO) QoL (Bref) and the WHO - Disability Assessment Schedule (DAS). STATISTICAL ANALYSIS: The Fisher's exact test/chi-square test was used to compare categorical variables and the independent sample t test was used to analyze continuous variables. Analysis of covariance (ANCOVA) was used to compare the groups after controlling for potential confounding variables. Pearson's correlation was used for correlation analysis. RESULTS: Overall family burden, financial burden and disruption of family routines were significantly higher in schizophrenia patients compared to OCD although the groups did not differ with respect to other domains of family burden. On the WHO QoL, OCD patients were comparable to schizophrenia patients with respect to the psychological and social domains. On the WHO - DAS, both the groups were similar in all the domains except getting around. CONCLUSION: Severe OCD is associated with significant disability, poor QoL and high family burden, often comparable to schizophrenia. Therefore, there is an urgent need to increase the sensitivity among healthcare professionals to recognize and treat OCD.

The impact of traumatic brain injuries: a global perspective.

Traumatic brain injury (TBI), according to the World Health Organization, will surpass many diseases as the major cause of death and disability by the year 2020. With an estimated 10 million people affected annually by TBI, the burden of mortality and morbidity that this condition imposes on society, makes TBI a pressing public health and medical problem. The burden of TBI is manifest throughout the world, and is especially prominent in Low and Middle Income Countries which face a higher preponderance of risk factors for causes of TBI and have inadequately prepared health systems to address the associated health outcomes. Latin America and Sub Saharan Africa demonstrate a higher TBI-related incidence rate varying from 150-170 per 100,000 respectively due to RTIs compared to a global rate of 106 per 100,000. As highlighted in this global review of TBI, there is a large gap in data on incidence, risk factors, sequelae, financial costs, and social impact of TBI. This should be addressed through planning of comprehensive TBI prevention programs in LMICs through well-established surveillance systems. Greater resources for research and prioritized interventions are critical to promote evidence-based policy for TBI.